Table of ContentsView AllTable of ContentsDefinitionWhy It’s OutdatedSymptoms and CriteriaDiagnostic ProcessCausesTreatmentCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Definition
Why It’s Outdated
Symptoms and Criteria
Diagnostic Process
Causes
Treatment
Coping
Frequently Asked Questions
Undifferentiated schizophrenia is an outdated term for a type ofschizophreniain which a person meets the criteria for the disorder but cannot be classified into just one of its foursubtypes. While undifferentiated schizophrenia is no longer listed in the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Disorders (DSM), some healthcare providers still use the term.
Under the older definition, people with undifferentiated schizophrenia exhibit symptoms of more than one type of schizophrenia. These may includedelusions,paranoia,hallucinations, and other symptoms that interfere with a person’s sense of reality.
This article explains what undifferentiated schizophrenia is and why the term is no longer widely used in the medical community. It also describes the symptoms of undifferentiated schizophrenia as well as the causes, diagnosis, and treatment of schizophrenia in the current context.
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Definition of Undifferentiated Schizophrenia
Schizophrenia is a mental health condition that interferes with a person’s perception of reality. In earlier editions of the DSM, schizophrenia was divided into five subtypes. undifferentiated schizophrenia essentially served as a catch-all diagnosis when someone’s symptoms did not fit neatly into any other category.
Why the Term Is No Longer Used
The most recent edition of the DSM (DSM-5) no longer includes any of the five subtypes of schizophrenia. According to the American Psychiatric Association, the classifications have not proven to be reliable in diagnosing schizophrenia and do not reflect the broad diversity of symptoms that can occur in people with schizophrenia.
And just as undifferentiated schizophrenia was an “other” category of schizophrenia that could potentially lump a variety of very different cases under one diagnosis, residual schizophrenia enabled a diagnosis even if the symptoms weren’t all that striking. Both subtypes were problematic as they could lead to misdiagnoses and inappropriate treatment.
Symptoms and Diagnostic Criteria
How symptoms would lead to adiagnosis of schizophreniais very different today than in previous editions of the DSM.
With this in mind, the symptoms of schizophrenia are broken down into five broad categories in the DSM-5:
In order to be diagnosed with schizophrenia today, under the DSM-5, you must:Exhibit at least two of these, with at least one being delusions, hallucinations, or disorganized speech, most of the timeHave symptoms that persist for at least six months and cause significant difficulty in one or more major life areas, such as work, interpersonal relations, or self-care
In order to be diagnosed with schizophrenia today, under the DSM-5, you must:
Then vs. Now
To be diagnosed with schizophrenia under the criteria set out in previous editions of the DSM, one of the following had to apply:
Based on which combination of symptoms a person had, or which symptoms predominated, a person could be classified as having either paranoid, disorganized, or catatonic schizophrenia.
If symptoms were not profound or specific enough to meet the criteria for these subtypes, a diagnosis of undifferentiated schizophrenia would be made.If a person had a schizophrenic episode but no longer had delusions, hallucinations, or disorganized speech, a diagnosis of residual schizophrenia would be made.
Schizophrenia SpecifiersWhile there are no longer categories of schizophrenia, there are certain “specifiers” that can help characterize the nature of a person’s disease. These include specifiers that describe the severity of symptoms, whether a person has catatonia, and if they have had complete or partial remission. Specifiers can direct which drugs or therapies are most appropriate.
Schizophrenia Specifiers
While there are no longer categories of schizophrenia, there are certain “specifiers” that can help characterize the nature of a person’s disease. These include specifiers that describe the severity of symptoms, whether a person has catatonia, and if they have had complete or partial remission. Specifiers can direct which drugs or therapies are most appropriate.
Schizophrenia Diagnosis Process
Identifying and classifying the symptoms requires the expertise of a psychiatrist or other certified mental health professional. They are trained to classify and characterize symptoms under a strict set of criteria based on observation and interviews.
Other tests may be ordered to rule out somatic (physical) causes of your symptoms.
What Causes Schizophrenia?
Examination
During an examination, a healthcare provider will:
Lab Tests
There is no lab test that confirms or rules out a diagnosis of schizophrenia. Blood, urine, or other lab tests may be ordered to identify other possible conditions that may explain the person’s symptoms.
Depending on the situation, a healthcare provider may order a blood or urine test to identify the presence of medications or illicit drugs that could be causing the symptoms.
Imaging Tests
A magnetic resonance imaging (MRI) or a computerized tomography (CT) may be ordered if there is concern that there could be an underlying physical cause for the symptoms, such as a brain tumor.
Age
While undifferentiated schizophrenia can occur at any age, symptoms usually begin during the age range of the late teens to the early thirties.
Genetics
Schizophrenia appears to run in families. Having schizophrenia in the family does not mean a person will develop schizophrenia, but it increases the risk.
Compared to the 1% prevalence of schizophrenia in the general population, there is a 10% prevalence among people who have a biological parent or sibling with schizophrenia. The highest risk is associated with identical twins.
Having a second-degree relative such as an aunt, uncle, grandparent, or cousin who has schizophrenia also increases a person’s chances of developing the condition.
It is likely that multiple genes are involved in the development of schizophrenia.
Environment
It is believed that the interaction between genetics and environmental factors influences the development of schizophrenia.
Some environmental risk factors include:
Substance Use
Drugs do not independently cause undifferentiated schizophrenia, but some drugs have been linked to an increased risk of schizophrenia in those who are susceptible.
Schizophrenia is linked most closely with use of:
Brain Chemistry
Dysfunctions of the neurotransmitters dopamine, serotonin, norepinephrine, and epinephrine have been linked to schizophrenia.
More specifically, excessive dopamine activity is linked to hallucinations, agitation, and delusions, while abnormalities in norepinephrine are linked to negative and cognitive symptoms of schizophrenia.
Brain Physiology
Differences in brain structure and function are believed to play a part in schizophrenia.
For example:
Although undifferentiated schizophrenia is no longer a recognized category in the DSM-5, the way it was treated in the past is essentially the same as how schizophrenia is treated today.
Both then and now, the treatment is individually tailored based on the types, severity, and duration of symptoms a person has. Specifiers can further direct which treatments are the most useful and which are the least.
Available treatment options are outlined below.
Medication
Some antipsychotics include:
Side effects of antipsychotics may include:
Some people may be prescribed mood stabilizers such as:
In some cases, people with schizophrenia may be prescribed antidepressants such as:
Never Go “Cold Turkey"Stopping psychiatric medication abruptly can be dangerous. Always consult your healthcare provider before stopping your medication or changing your medication plan.
Never Go “Cold Turkey”
Stopping psychiatric medication abruptly can be dangerous. Always consult your healthcare provider before stopping your medication or changing your medication plan.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a type of ongoing therapy that can be effective for treating many psychiatric conditions.
With CBT, people who have schizophrenia can learn to identify maladaptive thought patterns and learn how to challenge them, and change the thoughts and their accompanying behaviors.
Family Education and Support
These programs are geared toward the family members and close friends of people who have schizophrenia. They aim to help loved ones understand the condition, learn ways to support the person who has schizophrenia, and find support for themselves.
These programs can be done individually, as a family, or as a group with other families.
Coordinated Specialty Care
This type of treatment involves a team of specialists working together to provide help such as:
It may be particularly helpful for people in an early stage of schizophrenia called first-episode psychosis.
Assertive Community Treatment (ACT)
ACT aims to reduce the number of hospitalizations for people with schizophrenia and to decrease the number of people without housing.
It involves:
Social Skills Training
This treatment uses rehearsing or role-playing real-life situations to help a person with schizophrenia re-learn how to act and interact appropriately in social settings.
Supported Employment
This program helps people with schizophrenia enter the workforce with support, such as assistance with constructing resumes, preparing for job interviews, and connecting them with employers who hire and support people with mental illness.
Substance Use Treatment
Excessive substance use can make schizophrenia symptoms worse. Up to 50% of people with schizophrenia have substance use disorders. Substance use treatment is often a part of the treatment program for schizophrenia.
Help Is AvailableIf you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see thisNational Helpline Database.
Help Is Available
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see thisNational Helpline Database.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
For more mental health resources, see thisNational Helpline Database.
Schizophrenia is a life-long condition, so finding coping strategies is important.
Some helpful tips for those living with schizophrenia include:
Finding Support
Living with schizophrenia is difficult to do alone. Having the support of others can make the treatment and management of schizophrenia more effective and make life with schizophrenia more enjoyable.
Some ways to find support include:
Online Support Groups Can Be A Great ResourceSome online resources for people with undifferentiated schizophrenia include:National Alliance on Mental Health1-800-950-6264Brain and Behavior Research Foundation: 800-829-8289Schizophrenia and Related Disorders Alliance of America: 800-493-2094SAMHSA Early Serious Mental Illness Treatment LocatorSAMHSA Behavioral Health Treament Services Locator
Online Support Groups Can Be A Great Resource
Some online resources for people with undifferentiated schizophrenia include:National Alliance on Mental Health1-800-950-6264Brain and Behavior Research Foundation: 800-829-8289Schizophrenia and Related Disorders Alliance of America: 800-493-2094SAMHSA Early Serious Mental Illness Treatment LocatorSAMHSA Behavioral Health Treament Services Locator
Some online resources for people with undifferentiated schizophrenia include:
A Word From Verywell
Undifferentiated schizophrenia is no longer listed in the DSM, and healthcare providers are moving away from using this term as a diagnosis. Schizophrenia can be hard to recognize and difficult to live with, but with proper support and treatment, it can be manageable.
If you are experiencing symptoms of schizophrenia, book an appointment to see your healthcare provider or a mental health professional to get a proper diagnosis and find a treatment plan that works for you.
Frequently Asked QuestionsUndifferentiated schizophrenia is an outdated diagnosis for people who meet the criteria for schizophrenia but whose symptoms do not align with any of the four schizophrenia subtypes (also outdated). Today, there is only one category of schizophrenia. It affects approximately 1 in 300 people worldwide.Although schizophrenia is a life-long condition, it can often be effectively managed with treatment. The same may not be true for a related condition calledschizophreniform disorder, a short-term psychotic condition that generally lasts for one to six months.
Undifferentiated schizophrenia is an outdated diagnosis for people who meet the criteria for schizophrenia but whose symptoms do not align with any of the four schizophrenia subtypes (also outdated). Today, there is only one category of schizophrenia. It affects approximately 1 in 300 people worldwide.
Although schizophrenia is a life-long condition, it can often be effectively managed with treatment. The same may not be true for a related condition calledschizophreniform disorder, a short-term psychotic condition that generally lasts for one to six months.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What is schizophrenia?Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health.Cleveland Clinic.Schizophrenia diagnosis and tests.National Institute of Mental Health.Schizophrenia.Nurseslabs.Schizophrenia nursing care and management.Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G.Substance abuse in patients with schizophrenia.Dialogues Clin Neurosci. 2006;8(1):37-43. doi:10.31887%2FDCNS.2006.8.1%2FbwinklbaurHelpGuide.Schizophrenia treatment and self help.World Health Organization.Schizophrenia.National Institute of Mental Health.Schizophrenia.Heckers S, Barch DM, Bustillo J, et. al.Structure of the psychotic disorders classification in DSM-5.Schizophr Res. 2013 Oct;150(1):11-4. doi:10.1016/j.schres.2013.04.039
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What is schizophrenia?Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health.Cleveland Clinic.Schizophrenia diagnosis and tests.National Institute of Mental Health.Schizophrenia.Nurseslabs.Schizophrenia nursing care and management.Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G.Substance abuse in patients with schizophrenia.Dialogues Clin Neurosci. 2006;8(1):37-43. doi:10.31887%2FDCNS.2006.8.1%2FbwinklbaurHelpGuide.Schizophrenia treatment and self help.World Health Organization.Schizophrenia.National Institute of Mental Health.Schizophrenia.Heckers S, Barch DM, Bustillo J, et. al.Structure of the psychotic disorders classification in DSM-5.Schizophr Res. 2013 Oct;150(1):11-4. doi:10.1016/j.schres.2013.04.039
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychiatric Association.What is schizophrenia?Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health.Cleveland Clinic.Schizophrenia diagnosis and tests.National Institute of Mental Health.Schizophrenia.Nurseslabs.Schizophrenia nursing care and management.Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G.Substance abuse in patients with schizophrenia.Dialogues Clin Neurosci. 2006;8(1):37-43. doi:10.31887%2FDCNS.2006.8.1%2FbwinklbaurHelpGuide.Schizophrenia treatment and self help.World Health Organization.Schizophrenia.National Institute of Mental Health.Schizophrenia.Heckers S, Barch DM, Bustillo J, et. al.Structure of the psychotic disorders classification in DSM-5.Schizophr Res. 2013 Oct;150(1):11-4. doi:10.1016/j.schres.2013.04.039
American Psychiatric Association.What is schizophrenia?
Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 changes on the national survey on drug use and health.
Cleveland Clinic.Schizophrenia diagnosis and tests.
National Institute of Mental Health.Schizophrenia.
Nurseslabs.Schizophrenia nursing care and management.
Winklbaur B, Ebner N, Sachs G, Thau K, Fischer G.Substance abuse in patients with schizophrenia.Dialogues Clin Neurosci. 2006;8(1):37-43. doi:10.31887%2FDCNS.2006.8.1%2Fbwinklbaur
HelpGuide.Schizophrenia treatment and self help.
World Health Organization.Schizophrenia.
Heckers S, Barch DM, Bustillo J, et. al.Structure of the psychotic disorders classification in DSM-5.Schizophr Res. 2013 Oct;150(1):11-4. doi:10.1016/j.schres.2013.04.039
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